Mentalizing the modern world

Abstract

A theoretical paper in which the theory of mentalizing and epistemic trust are applied to thinking about the relationship between social systems and individual subjective experiences, and how this relationship may be shaped by developmental history, such as attachment experiences, exposure to childhood adversity, and the experience of being mentalized. We suggest that the experience of being mentalized and openness to epistemic trust may be the mechanism by which individual experiences of psychic distress, perception of self-agency and perceptions of others, are both influenced by and shape wider social phenomena and social change. We consider the impact of social inequalities and the breakdown of political legitimacy on mentalizing, epistemic trust and psychopathology, and argue that optimal individual outcomes cannot always be achieved without adaptation of the wider social environment.

Keywords:

• mentalizing
• epistemic trust
• culture

Introduction

The question we would like to explore in this paper is how mentalizing theory, and recent extensions of the theory into the areas of epistemic trust and social communication, can be used to think more broadly about the relationship between social systems and individual social functioning. Mentalizing is defined as the imaginative capacity to think about behaviour (both one’s own and others’) in terms of the mental states (thoughts, feelings and beliefs) that underpin them. Epistemic trust denotes the capacity to absorb and recognise the personal relevance of new knowledge offered by trusted communicators. In previous communications (Fonagy et al., 2015), we have argued that the development of a capacity for epistemic trust is facilitated by the caregiver’s mentalizing of the child. In this paper, we would like to develop the implications of the idea that in order to experience a meaningful engagement with their social environment, the individual needs to feel that s/he is recognised as an agent and that s/he is being mentalized by the social system (Fonagy et al., 2021). Mentalizing theory has always maintained that when our immediate social context does not provide this kind of experience, we are vulnerable to the development of psychopathology. We propose that we may be able to identify the mechanism for the observable relationship (Macintyre et al., 2018) between psychopathology and socio-economic alienation and inequality in the disadvantaged individual’s experience of a broader social context that fails to take into account the subjective richness of the individual minds of those with less (or even without) economic value or social capital, as is the case in highly unequal social systems. Further, we consider some of the implications for legitimacy and the social contract when reduced co-mentalizing brings about an ‘epistemic mismatch’ in relation to social communication.

From dyad to broader social context

Clinicians are often forced to confront the problem of trying to help a person to function when they are living in a non-mentalizing social system in their day-to-day lives – an anxious child in an intimidating school environment, for example. So, although this is not a new or previously unconsidered problem (Macintyre et al., 2018), we want to make the case that mentalization theory can help us to address this difficulty in a way that is clinically and conceptually useful and that enables us to understand how the social environment, and in particular situations of powerlessness and inequality, impact on individual psychosocial experiences. Traditionally, the theory tended to focus on mentalizing within the microcosms of the caregiving and therapeutic dyads (Fonagy et al., 2002). While it is recognised that early relationships are the crucibles of development – the role of early attachment and mentalizing caregivers in supporting children’s social functioning is well-evidenced (Groh et al., 2014; Luyten et al., 2020) – we have not paid enough attention to the fact that the dyad is operating within and responding to a wider mentalizing social system. We have recently argued that the relationship between culture and psychopathology needs to be reconsidered in order to address this oversight, and that more attention needs to be paid to the psychosocial implications of the idea that social inequalities are perpetuated by discounting individuals’ agency and subjectivity (Fonagy et al., 2021).

Since its inception the mentalizing approach to understanding both normal and disrupted development has maintained that the capacity to mentalize is first acquired in the context of attachment relationships. Parental mentalizing, or parental reflective functioning (PRF), is associated with the development of secure attachment and reflective functioning and, consequently, emotion regulation and interpersonal functioning in the child (for a comprehensive review, see Luyten et al., 2017, 2020). Caregivers with high levels of PRF are assumed to be able to respond with contingent and marked affective mirroring of the child’s displays of emotion, fostering the development of second-order representations of his/her subjective experiences (Luyten et al., 2017).

More recently, developments in the theory have begun to bring the social environment surrounding the dyad into focus (Fonagy et al., 2021). In particular, recent work has emphasised that both the caregiver’s capacity to mentalize the child, which begets epistemic trust, and the child’s ability to make optimal use of their capacity to learn, require a facilitating environment. That is, caregivers require a social context that provides them with the support they need to sustain their mentalizing capacity in the face of the inevitable challenges of development and the strains of parenting, and more broadly creates a cultural context in which it is reasonable to expect to have one’s thoughts and feelings taken into account. We have ample evidence, for example, that the neighbourhood and its perceived safety is a risk factor in mental health (Lund et al., 2018) and that social exclusion is a particularly salient factor in explaining reduced mental health in children with reduced material resources (Gross-Manos, 2017). We also know that disorganized attachment is as equally associated with deprivation as with trauma (Cyr et al., 2010). Hitherto we have tended to assume that this is mediated through caregiver sensitivity, although as yet the ‘transmission gap’ – a term coined by van IJzendoorn to capture uncertainty about what aspects of parenting behaviour explain the intergenerational transmission of attachment patterns (van IJzendoorn, 1995) – has not been entirely closed (van IJzendoorn & Bakermans-Kranenburg, 2019; Verhage et al., 2016). Reflective and sensitive parenting is of course much harder for anyone in very stressful circumstances, but perhaps the role of the wider social environment in relation to attachment as well as other vulnerability factors needs to be more directly considered (Macintyre et al., 2018)

While the primary function of attachment is of course the provision of safety through proximity to the caregiver and the safeguarding and emotional regulation that this delivers, evolution has also invested the attachment relationship with multiple other developmental functions. When a caregiver responds sensitively and contingently to an infant’s needs, this also communicates interest and investment in their survival, and indicates that the caregiver is sufficiently sustained by physical and social resources to respond generously to them. From this perspective, an avoidant attachment style might be regarded as an adaptation to an environment in which greater self-reliance and detachment from others might be an advantage, while a resistant attachment strategy might be effective in an unpredictable and inconsistent environment; this point has been cogently argued by attachment theorists such as Belsky and Mikulincer (Belsky, 2006; Mikulincer & Shaver, 2007; Simpson & Belsky, 2008). Humans are capable of generating a wide variety of cultural and social milieux in response to their circumstances, and our ability to adapt to these diverse environments involves and depends upon the ability to parent in different ways, as the work of anthropologists such as Sarah Blaffer Hrdy has demonstrated (Hrdy, 2011). Attachment may thus be understood as one of the ‘cultural acquisition devices’ described by the anthropologist Konner in his depiction of human childhood as a process of enculturation (Konner, 2010). The attachment researcher Mesman has posited the compelling notion of ‘received sensitivity’, assessed by a Received Sensitivity Scale, to allow for the infant’s experience of care from multiple sources in conditions where alloparenting is more prevalent (Mesman et al., 2016). ‘Received mentalizing’ or an individual’s mentalizing quotient may have a similar enculturating function, as we shall consider next.

Reframing mentalizing deficits as adaptations

One of the evolutionary benefits of mentalizing might be to facilitate adaptation to the social environment: a parent’s limited mentalizing of their child may be strategically necessary to prepare the child for a social world where experiences of such limitation will be the norm, perhaps because of scarcity of resources. The capacity to mentalize maximises the individual’s social functioning by enabling them to reap the benefits of cooperation made possible by intersubjective interaction (Tomasello, 2014). The human capacity for such higher order cognition most likely emerged as an adaptation to living in small social groups in which there was less differentiation between interactions involving the dyad, other alloparents, wider family life, community and work (Dunbar, 1996). If one thinks about the emergence of mentalizing in this environment, where there was so much less separation between these social spheres, the broader socialisation implications of early experiences of being mentalized become much more obvious.

In the past, we have used the analogy of language acquisition to describe the development of mentalizing in young children. We are prewired to learn language but not to acquire any one single language. Similarly, we need to be open to learning a variety of ‘languages’ for thinking and talking about mental states, and we learn the most appropriate mentalizing language for our social context by interacting with our social group. A recent cross-cultural study shows how cultural influences shape our language of mentalizing, with more individualistic cultures tending to encourage a greater emphasis on mentalizing the self, while more collectivist cultures emphasise the mentalizing of others (Aival-Naveh et al., 2019). We suggest that other forms of cultural variability may influence our mentalizing languages, such as the impact of living in a society in which there is a greater operation of the non-mentalizing modes that underpin higher levels of interpersonal violence or political silencing via exclusion or discrimination. In such an environment, different mentalizing profiles might be optimal, and epistemic trust in others may be reduced.

When to trust and when to remain vigilant

The concept of epistemic trust, or openness to the communication of knowledge from other minds, was developed in dialogue with the work of the developmental researchers George Gergely and Gergely Csibra, who have argued that infants have a natural predisposition to learn from others, known as natural pedagogy (Csibra & Gergely, 2011). According to this thinking, ostensive cues from the caregiver open the infant up to learning. The term was borrowed from Bertrand Russell to describe signals used by an agent to alert the addressee that the agent is about to communicate relevant pieces of cultural knowledge. Ostensive cues are signals that what is about to be communicated is useful information for the infant. They may include eye contact, turn-taking contingent reactivity, and the use of a special vocal tone (‘motherese’), all of which are provided by the experience of being mentalized. We contend that the caregiver’s mentalizing of the infant also serves as an ostensive cue that opens the infant up to learning. Epistemic trust is necessary to enable us efficiently to absorb the cultural knowledge that helps us to navigate the environment that our cargivers are socializing us into (Fonagy et al., 2015, 2017b). However, if thinking about other minds is aversive, or if others’ motivations cannot be assumed to be benign, then it may be more adaptive to close down that channel of communication via epistemic trust. Recently we have argued that some forms of psychopathology might best be understood not as resulting from a deficit but as an evolutionarily driven form of entrenched adaptation to stimuli from the social environment – often in interaction with genetic propensity (Fonagy et al., 2017a, 2017b).

The trust that opens the channel for the transmission of social knowledge is not our default setting. There are many situations in which a position of epistemic vigilance – or outright epistemic mistrust – might be a safer one to adopt. In Fonagy and colleagues’ recent thinking about the role played by hypervigilance and epistemic petrification in the development of psychopathology and personality disorder, the focus has been on anomalies of parent-infant communication whose common feature is the absence of respect for the recipient of communications as an active agent (Fonagy et al., 2015). Such challenges in the immediate social environment are thought to lead to an adaptive hypervigilance and blocking the channel for social knowledge transmission. Recent empirical work is indeed suggestive of a relationship between developmental experiences, mentalizing and disruptions in epistemic trust, as measured in a recently created and validated questionnaire – the Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ) (Campbell et al., 2021). Here we conceptualized disruptions in epistemic trust as having two possible expressions. The first is mistrust, which manifests as a tendency to treat any source of information as unreliable or ill-intentioned. The second form of epistemic disruption we measured is epistemic credulity, which involves a lack of vigilance and discrimination, potentially resulting in vulnerability to misinformation and risk of exploitation. It was found that both Mistrust and Credulity were associated with childhood adversity and higher scores on the global psychopathology severity index, and both factors partially mediated the link between early adversity and mental health symptoms. High Mistrust and Credulity were also associated with poorer mentalizing and insecure attachment styles.

The developmental and evolutionary psychologist Tomasello has written extensively about what is unique about human cooperation. He has pointed out that human cooperative thinking involves the coordination of perspectives (O’Madagain & Tomasello, 2019; Tomasello, 2019). Coordination draws on quite a complicated triangle of understandings: it is dependent on drawing a distinction between what one is thinking oneself and what the other person/s is thinking and viewing both these perspectives in relation to the actual physical reality of what is ‘out there’ – the issue that each party is actually focused on. Such attention and coordination of perspectives generates a particular subjective experience of social cognition that has been labelled ‘we-mode’ (Gallotti & Frith, 2013; Higgins, 2020). The we-mode, or as we have also termed it co-mentalizing or relational mentalizing, is a mental state describing an interpersonal experience where intentional states are shared and joined together with a common purpose. The we-mode broadens awareness of the options available for action and generates new solutions (Gallotti & Frith, 2013). Considerable benefits arise from being able to form this kind of we-mode when we are facing complex and demanding issues: different knowledge and perspectives can be drawn on to resolve a problem that one person alone does not have the capability to deal with. It is not surprising that as a species we are motivated to share our inner states (beliefs, mental states) and understanding of the social world (Hardin & Higgins, 1996), because this convergence of mentalizing gives us greater confidence when it comes to communicating with other people and it contributes to the formation and the maintaining of social bonds. There is much to be gained in terms of collaboration and cooperative social functioning from being open to operating in the we-mode, but our ability to operate in this way depends on our capacity both to mentalize others and recognise others’ mentalizing representations of us (Fonagy et al., 2021), which in turn depend on experiences of a social context that facilitates the development of these capacities.

Mentalizing in a non-mentalizing environment

Let us now consider the situation of a family operating within a wider social system that does not value mentalizing, whose functioning depends on denying certain groups recognition of their agency and selfhood. In such circumstances, it may not be possible to regard representatives of local institutions, neighbours, school teachers, and even relatives as trustworthy. This presents the ‘good enough’ parent with a difficult dilemma: the consequence of mentalizing-rich parenting that stimulates epistemic trust, which might be adaptive in more benign circumstances, could potentially engender vulnerability in someone growing up in a more threatening milieu.

We would suggest that one way in which a caregiver may seek to resolve this dilemma is by ring-fencing certain aspects of behaviour and affect that are potentially dangerous, and excluding them from the usual repertoire of ‘marked mirroring’ responses. For example, violent or aggressive behaviour might not be responded to in a way that enables the child to register the effects, implications and even origin of their anger in themselves – this might be adaptive in a social environment in which there are high rates of violent crime. Similarly, particularly expansive and open behaviours (i.e., very overt expressions of epistemic trust) might be responded to with a subduing blankness of parental response: in other words, and perhaps paradoxically, the epistemic channel between caregiver and child might be used to communicate to the child a need for epistemic vigilance. That is how some parents might respond. But others are likely to communicate the limited scope for the acknowledgement of agency in the prevailing social climate in a less nuanced way, through more generalised denials of the infant’s subjective state.

In a social system (this can include a family, a school, a hospital or workplace, a neighbourhood or indeed a national culture) where epistemic trust has broken down, it becomes increasingly difficult for individuals to experience themselves as agents. This will become accentuated when an individual also has personal experience of the need for epistemic vigilance in their immediate social environment. In these circumstances, the individual may also become less receptive to ostensive cues that might help build agency for three reasons, all of which arise from a breakdown in mentalizing.

1. The individual becomes unable to see the self as self (poor mentalizing of the self, in which one’s own agency is not recognised).

2. The ostensive cues of others are not appropriately recognized for what they are, because the individual is unable to mentalize the other.

3. A non-mentalizing system can easily become one that evokes fear. If the individual is frightened of the other, s/he may scotomize the other’s attempt to mentalize.

In the modern state, the need for epistemic trust becomes more acute because of greater numbers, social complexity and diversity, and because of the larger and more disconnected functioning of the state, and yet for the same reasons it also becomes more difficult to achieve. Social trust is required to help us to overcome the natural vigilance that we all feel towards ideas that are not ours and thus to support social cohesion. All humans are much more likely to be able to take in and consider the novel ideas of others if the individual feels that their thoughts are regarded seriously and their agency respected. To return to the idea of joint attention and the we-mode, we can think together with other minds in relation to an object (a novel idea dependent on cooperation for the sake of medium to longer term benefit, for example) only if we experience the epistemic match generated by a mutual recognition of subjective agency – that is, if I recognise myself in your representation of me. As an adolescent or an adult I am more likely to approach you with the expectation that I will be recognised in this way if I have had earlier experiences of this with caregivers, teachers and so on. But I am less likely to find what I am looking for in a culture where the distribution of wealth and power within it means that it is too easy to feel that the wider world has nothing to do with the things that matter to me. In such a world I may feel threatened when I encounter ideas that are not mine (and react with violence), especially if I have been primed to react in this way by my early experiences. Or – if they are presented very forcefully and with unshakable conviction – I may embrace them uncritically because they seem to offer a new sense of security and a way of seeing the world that I can trust. Then another process emerges – attachment to this alternative authority can become intense, and loyalty to that becomes more important than other social institutions.

Political legitimacy, social inequality and psychopathology

An interdisciplinary case study of the fluctuating history of homicide rates across time offers an illustration of the impact of the broader social context on the frequency of individual violent acts. One of the most convincing researchers in this area has been the Cambridge criminologist Manuel Eisner, who has considered the various factors connected with changing levels of violence. Rates of instrumental homicide, the type of homicide that fluctuates the most historically, are influenced by whether societies are ruled by law, whether elites are trusted, whether corruption is under control, and whether services are provided; in short, they are influenced by the fair and effective functioning of social institutions and perceived legitimacy of the state (Eisner, 2012). This model of political legitimacy has been tested against cross-national homicide rates and other variables (such as proportion of young males in the population, infant mortality, population growth and GDP), and found to be a consistently strong and independent predictor. Historical research and cross-cultural criminological evidence suggests that establishing faith in the government and confidence that its legal and judicial institutions are fair and will redress wrongs and protect lives and property is the most significant requirement for homicide rates to fall.

Legitimacy is the rather abstract term used by historians and political scientists to describe individuals’ confidence in the social and political structure. It has its origins in political philosophy in ideas about the social contract – the notion that a government can only function, and can only justify its existence, if the population has sufficient confidence in its intentions and effectiveness, and that a government that breaks the social contract is the agent of its own destruction. We would suggest that the psychological mechanism that underpins concepts like legitimacy and the social contract involves epistemic trust. Perhaps one of the clearest manifestations of the disregard for the agency and subjectivity of the other that characterises inequality is in colonial societies and ideas about the ‘native mind’ and its limitations. The psychological cost of this discounting of the mind of the other was originally described by the psychiatrist Frantz Fanon. One of Fanon’s important insights was that the cognitive distortions involved in operating in this way were psychologically damaging for everyone within that system (Fanon, 2021). This idea has an empirical parallel in recent work on the effects of inequality on mental health across society – that social inequality beyond a certain tipping point is associated with increasing distress across the social spectrum, albeit with greater vulnerability in the most deprived (Pickett & Wilkinson, 2010). Instructive too, for those with an interest in mentalization-based treatment and its focus on borderline personality disorder, is a possible association between economic inequality and increasing prevalence of BPD (Luyten et al., 2019). Different epochs have each tended to have their own defining psychopathology, which can tell us something about what ailed the culture as well as what ails the individual. For Freud (arguably at his most Victorian), it was hysteria; melancholia was a preoccupation in the 16^th and 17^th centuries. Pre-modern societies are thought to manifest higher levels of somatising disorders. The concept of borderline personality disorder speaks perhaps most clearly to the contemporary psyche in distress in western societies. Perhaps the first observer of this was Durkheim, with his description of anomie arising from social alienation (Durkheim, 1951): the fragmentation and destruction of social bonds that come with modernity. Indeed, it is striking that as Bowlby was creating the theory of attachment in the 1950s and 1960s, sociologists were conspicuously preoccupied with the absence of attachment in the form of alienation, normlessness and marginality. Latour has powerfully argued that the ‘epistemological delirium’ created by climate change and its denial is creating a contemporary escalation in the breakdown of the possibility of co-mentalizing: ‘The terrifying impression that politics has been emptied of its substance, that it is not engaged with anything at all, that it no longer has any meaning or direction, that it has become literally powerless as well as senseless, has no cause other than this gradual revelation: neither the Global nor the Local has any lasting material existence’ (Latour, 2018, p. 39).

We are highly evolved to monitor ostensive cues and to raise our level of epistemic vigilance when these cues are absent or non-contingent with our needs. It is in our interest to behave in this way. A cultural milieu in which political authorities and social institutions neglect citizens’ needs and/or abuse their rights will close down the channel of natural pedagogy. Cultural knowledge and expectations may be recognised and understood, but they are no longer experienced as relevant and generalisable to the individual concerned. In other words, they are stored as episodic rather than semantic memories. Social alienation is in a sense a systemic breakdown in epistemic trust directed towards the wider environment.

The case for systemic intervention

When the state’s legitimacy is eroded not everyone responds with physical aggression. We would suggest that one of the moderating factors that determines whether an individual is likely to act violently is their pre-existing capacity for mentalizing (Taubner et al., 2013, 2016). In a situation where epistemic trust in the wider social environment has broken down, an increasing strain is placed on the individual’s capacity to feel a sense of agency, and this is particularly challenging for those who are already struggling to experience themselves in this way. Ostensive cues are not recognised as such and others’ attempts to mentalize will either not be identified as such, or be experienced as hostile intrusions. Individuals who are more prone to slip into non-mentalizing modes of subjectivity are more likely to act violently or become dysregulated (Fonagy et al., 2017a, 2017b). As suggested above, in a highly non-contingent, non-mentalizing social system there may be advantages to operating in such non-mentalizing modes. However, restoring healthy mentalizing will depend on the extent to which it was possible to establish this capacity in early experience. It also requires adjustments to be made to create a space to scaffold the development of a mentalizing capacity.

In thinking about the relationship between mentalizing and social communication, we hope to begin a discussion that can take the theory beyond the dyad. Culture would not be possible without the ability to hold other minds in mind (Tomasello, 2014). The current climate shows more starkly than ever that the flipside, the failure to mentalize the other, and the social communication collapse that this creates, can stimulate destabilizing socio-political discourse characterized by an escalating epistemic repudiation of the other. We suggest that mentalizing and epistemic trust might shed further light on the potency of the relationship between an individual’s experience of a non-mentalizing environment, their subjective wellbeing and social functioning, and their relationship with the body politic.

Disclosure statement

No potential conflict of interest was reported by the author(s).